儿童慢性肾脏疾病早期诊断的生物标志物研究进展OACSTPCD

The status of serum creatinine and proteinuria as the biomarkers for the progression of chronic kidney disease(CKD)is unquestioned,but it does not cover some other types of lesions.The latest studies have found the biomarkers reflecting different aspects of CKD that can provide the information in the risk of CKD progression and related poor prognosis.This review highlights some biomarkers for early diagnosis of CKD in children,including plasma kidney injury molecule-1(KIM-1),fibroblast growth factor(FGF-23),tumor necrosis factor receptor-1(TNFR-1),tumor necrosis factor receptor-2(TNFR-2),soluble urokinase-type plasminogen activator receptor(suPAR),human cartilage glycoprotein(YKL-40)as well as urine epider-mal growth factor(EGF),alpha-1 microglobulin,KIM-1,and YKL-40.Studies have discovered that the levels of these plasma and urine biomarkers are higher in children with CKD even after adjusting for serum creati-nine or estimated glomerular filtration rate and proteinuria,which are independently correlated with the CKD progress.These novel biomarkers represent the different biologic pathways of renal tubular injury,renal tubu-lar dysfunction,inflammation and renal tubular health and can be used as the liquid biopsy to better describe the disease characteristics of CKD in children.Novel blood and urine biomarkers improve the clinicians'ability to assess the prognosis for CKD progression and may improve understanding of the pathophysiology of CKD.H owever,for the preclinical biomarkers associated with CKD outcomes,there is considerable heterogeneity be-tween study cohorts and designs,limiting the comparison of prognostic performance between different stud-ies.Larger clinical studies are needed to determine how these biomarkers could be used in the clinic to improve the clinical management of CKD.